Dr. Sam Eljamel Profile

Dr. Sam Eljamel

at Ninewells Hospital and Medical School

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Proceedings Article | 13 July 2009 Paper

Which intracranial lesions would be suitable for fluoresce guided resection?: A prospective review of 110 consecutive lesions

M. Sam Eljamel

Proceedings Volume 7380, 73800U (2009) https://doi.org/10.1117/12.822618

KEYWORDS: Tumors, Luminescence, Brain, Surgery, Tissues, Tissue optics, Cancer, Blood, Photodynamic therapy, Fluorescence spectroscopy

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Fluorescence guided surgical resection is based on the basic principle that photosensitizers are preferentially taken up and retained by cancer cells and the these sensitizers absorb light in one band of the light spectrum and release the energy as fluorescence that can be visualised in a different band of the spectrum. This study reports fluorescence outcome of 110 consecutive intracranial tumors to identify its potential benefits during fluorescence guided resection (FGR). The specificity of this technique was very high with no false positive results. Its sensitivity varied from 83.7% in brain lung metastasis to 85.7% in glioblastomas. A wide range of other intracranial tumors were also studied but the numbers in each of these subgroups were small to deduct its usefulness. However, grade III astrocytomas, primary cerebral lymphoma and meningiomas fluoresced very well in all patients. FGR would be therefore very useful aid during a wide range of intracranial tumor surgery with the advantages of specificity, high sensitivity and would not be affected by brain shift and tumor removal. The limitations of this technique were that the sensitivity was not 100% and it would be possible to miss 15% of tumors, blood can also obscure the fluorescence and it would be a problem in vascular tumors, and photo bleaching can reduce the fluorescence.

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